Arthroscopic Synovectomy

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Chronic synovitis not responding to maximal medical therapy
    • Rheumatoid arthritis
    • Recurrent hemarthrosis
    • Hemophilia
    • Pigmented villonodular synovitis
CONTRAINDICATIONS
  • Degenerative joint disease
  • Active infection
EQUIPMENT
  • Standard knee arthroscopy set
  • 70-degree viewing arthroscope
ANATOMY
  • The synovial membrane attaches to:
    • Margins of the articular surfaces
    • Superior and inferior outer margins of the menisci
  • Anteriorly, the synovial membrane forms a large suprapatellar bursa.
  • More laterally, it then extends beneath the aponeuroses of the vasti muscles.
  • Distally, it is separated from the patellar ligament by the infrapatellar fat pad, which it covers.
  • Moving posteriorly, the membrane folds then converge to form the infrapatellar fold or plica (ligamentum mucosum).
    • This then attaches in the femoral intercondylar fossa.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Remove the drain before patient discharge.
  • Weight-bearing to tolerance with crutches is allowed.
  • Range of motion and quadriceps-strengthening exercises are begun immediately.
COMPLICATIONS
  • Recurrent hemarthrosis
  • Joint stiffness and loss of extension
  • Infection and neurovascular injury
RESULT ANALYSIS
  • Synovectomy significantly decreases pain and synovitis in patients with rheumatoid arthritis at 2-4 years of follow-up.
  • Range of motion following arthroscopic synovectomy in patients with rheumatoid arthritis has been shown to improve 73% with 8 years of follow-up.
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